Anticonvulsant

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Anticonvulsant

The anticonvulsants are a diverse group of pharmaceuticals

Pharmacology

Pharmacology is the study of drug action. More specifically it is the study of the interactions that occur between a living organism and exogenous chemicals that alter normal biochemical function....
used in the treatment of epileptic

Epilepsy

Epilepsy is a common chronic neurological disorder characterized by recurrent unprovoked seizure s. These seizures are transient signs and/or symptoms of abnormal, excessive or synchronous neuronal activity in the brain....
seizure

Seizure

An epileptic seizure is a transient symptom of abnormal, excessive or synchronous neuronal activity in the brain. It can manifest as an alteration in mental state, tonic or clonic movements, convulsions, and various other psychic symptoms ....
s. Anticonvulsants are also increasingly being used the treatment of bipolar disorder

Bipolar disorder

Bipolar disorder is a Classification of mental disorders that describes a category of mood disorders, or mood swings, defined by the presence of one or more episodes of abnormally elevated mood clinically referred to as mania or, if milder, hypomania....
, since many seem to act as mood stabilizers. The goal of an anticonvulsant is to suppress the rapid and excessive firing of neuron

Neuron

Neurons are responsive cell in the nervous system that process and transmit information by electrochemical Signal . They are the core components of the brain, the vertebrate spinal cord, the invertebrate ventral nerve cord, and the peripheral nerves....
s that start a seizure. Failing this, a good anticonvulsant would prevent the spread of the seizure within the brain and offer protection against possible excitotoxic

Excitotoxicity

Excitotoxicity is the pathological process by which neuron are damaged and killed by glutamate and similar substances. This occurs when cell surface receptor for the excitatory neurotransmitter glutamic acid such as the NMDA receptor and AMPA receptor are overactivated....
effects that may result in brain damage

Brain damage

Brain damage, or acquired brain injury, is the destruction or degeneration of brain cells....
.

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Encyclopedia

The anticonvulsants are a diverse group of pharmaceuticals

Pharmacology

Epilepsy

Seizure

Bipolar disorder

Neuron

Excitotoxicity

Brain damage

Brain damage, or acquired brain injury, is the destruction or degeneration of brain cells....
. However, anticonvulsants themselves have been linked to lowered IQ in children. Anticonvulsants are often called antiepileptic drugs (abbreviated "AEDs") or antiseizure drugs (abbreviated "ASDs").

The major molecular targets of marketed anticonvulsant drugs are 1) voltage-gated sodium channels; 2) components of the GABA

Gamma-aminobutyric acid

γ-Aminobutyric acid is the chief inhibitory neurotransmitter in the mammalian central nervous system. It plays an important role in regulating neuronal excitability throughout the nervous system....
system, including GABA_{A receptors, the GAT-1 GABA transporter, and GABA transaminase; and 3) voltage-gated calcium channels.

Some anticonvulsants have shown antiepileptogenic effects in animal models of epilepsy. That is, they either prevent the expected development of epilepsy or can halt or reverse the progression of epilepsy. However, no drug has been shown to prevent epileptogenesisEpileptogenesis

Epileptogenesis is a process by which a normal brain develops epilepsy, a chronic condition in which seizures occur. The process, which is gradual, occurs in symptomatic epilepsy, in which seizures are caused by an identifiable lesion in the brain....
(the development of epilepsy after an injury such as a head injuryTraumatic brain injury

Traumatic brain injury occurs when an outside force physical trauma the brain. TBI can be classified based on severity, mechanism , or other features ....
) in human trials.

Approval

The usual method of achieving approval for a drug is to show it is effective when compared against placebo, or that it is more effective than an existing drug. In monotherapy (where only one drug is taken) it is considered unethical by most to conduct a trial with placebo on a new drug of uncertain efficacy. This is because untreated epilepsy leaves the patient at significant risk of death. Therefore, almost all new epilepsy drugs are initially approved only as adjunctive (add-on) therapies. Patients whose epilepsy is currently uncontrolled by their medication (i.e., it is refractory to treatment) are selected to see if supplementing the medication with the new drug leads to an improvement in seizure control. Any reduction in the frequency of seizures is compared against a placebo.

Once there is confidence that a drug is likely to be effective in monotherapy, trials are conducted where the drug is compared to an existing standard. For partial-onset seizures, this is typically carbamazepineCarbamazepine

Carbamazepine is an anticonvulsant and mood stabilizer drug used primarily in the treatment of epilepsy and bipolar disorder. It is also used to treat Attention-deficit hyperactivity disorder, ADHD, schizophrenia, phantom limb syndrome, paroxysmal extreme pain disorder, and trigeminal neuralgia....
. Despite the launch of over ten drugs since 1990, no new drug has been shown to be more effective than the older set, which includes carbamazepine, valproate and phenytoin. The lack of superiority over existing treatment, combined with the lack of placebo-controlled trials, means that few modern drugs have earned FDA approval as initial monotherapy. In contrast, Europe only requires equivalence to existing treatments, and has approved many more. Despite their lack of FDA approval, the American Academy of NeurologyAmerican Academy of Neurology

The American Academy of Neurology is a professional society for neurologists and neuroscientists. As a medical specialty society it was established in 1949 by A.B....
and the American Epilepsy Society still recommend a number of these new drugs as initial monotherapy.

Drugs

In the following list, the dates in parentheses are the earliest approved use of the drug.

Aldehydes
Main article: AldehydeAldehyde

An aldehyde is an organic compound containing a terminal carbonyl group. This functional group, which consists of a carbon atom bonded to a hydrogen atom and double bond to an oxygen atom , is called the aldehyde group....
s
ParaldehydeParaldehyde

Paraldehyde is the cyclic form of three acetaldehyde molecules . A colourless to pale yellow pungent liquid, it is sparingly soluble in water and highly soluble in alcohol....
(1882). One of the earliest anticonvulsants. Still used to treat status epilepticusStatus epilepticus

Status epilepticus refers to a life-threatening condition in which the brain is in a state of persistent seizure. Definitions vary, but traditionally it is defined as one continuous unremitting seizure lasting longer than 30 minutes , or recurrent seizures without regaining consciousness between seizures for greater than 30 minutes....
, particularly where there are no resuscitation facilities.

Aromatic allylic alcohols
StiripentolStiripentol

Stiripentol is an anticonvulsant drug used in the treatment of epilepsy. It is unrelated to other anticonvulsants and belongs to the group of aromatic allyl alcohols....
(2001 - limited availability). Indicated for the treatment of severe myoclonic epilepsy in infancy (SMEI).

Barbiturates
Main article: BarbiturateBarbiturate

Barbiturates are medication that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia....
s

BarbiturateBarbiturate

Barbiturates are medication that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia....
s are drugsMedication

A pharmaceutical drug, also referred to as medicine or medicament, can be loosely defined as any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease....
that act as central nervous system (CNS) depressantDepressant

Depressant is a chemical agent that diminishes the function or activity of a specific part of the body.The term is used in particular with regard to the central nervous system ....
s, and by virtue of this they produce a wide spectrum of effects, from mild sedationSedation

Sedation is a medical procedure involving the administration of sedative drugs, generally to facilitate a medical procedure with local anaesthesia....
to anesthesiaAnesthesia

Anesthesia, or anaesthesia , has traditionally meant the condition of having sensation blocked or temporarily taken away. This allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience....
. The following are classifiedATC code N03

N03 Antiepileptics is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System.It is part of the anatomical group ATC code N....
as anticonvulsants:

PhenobarbitalPhenobarbital

Phenobarbital or phenobarbitone is a barbiturate, first marketed as Luminal by Bayer. It is the most widely used anticonvulsant worldwide and the oldest still commonly used....
(1912). See also the related drug primidonePrimidone

Primidone is an anticonvulsant of the pyrimidinedione class whose active metabolites, phenobarbital and phenylethylmalonamide , are also anticonvulsants....
.
MethylphenobarbitalMethylphenobarbital

Methylphenobarbital, also known as mephobarbital, is a drug which is a barbiturate derivative.Methylphenobarbital is used as a sedative, anxiolytic and anticonvulsant....
(1935). Known as mephobarbital in the US. No longer marketed in the UK
MetharbitalMetharbital

Metharbital was patented in 1905 by Hermann Emil Fischer working for Merck KGaA. It was marketed as Gemonil by Abbott Laboratories. It is a barbiturate anticonvulsant, used in the treatment of epilepsy....
(1952). No longer marketed in the UK or US.
BarbexacloneBarbexaclone

Barbexaclone is a salt compound of phenobarbital and propylhexedrine. It was introduced in 1983. It is reported to be as effective as phenobarbital but better tolerated....
(1982). Only available in some European countries.

Phenobarbital was the main anticonvulsant from 1912 till the development of phenytoin in 1938. Today, phenobarbital is rarely used to treat epilepsy in new patients since there are other effective drugs that are less sedating. Phenobarbital sodium injection can be used to stop acute convulsions or status epilepticusStatus epilepticus

Status epilepticus refers to a life-threatening condition in which the brain is in a state of persistent seizure. Definitions vary, but traditionally it is defined as one continuous unremitting seizure lasting longer than 30 minutes , or recurrent seizures without regaining consciousness between seizures for greater than 30 minutes....
, but a benzodiazepine such as lorazepam, diazepam or midazolam is usually tried first. Other barbiturates only have an anticonvulsant effect at anaesthetic doses.

Benzodiazepines
Main article: BenzodiazepineBenzodiazepine

The benzodiazepines are a class of psychoactive drugs with varying hypnotic, sedative, anxiolytic , anticonvulsant, muscle relaxant and anterograde amnesia properties, which are mediated by slowing down the central nervous system....
s

The benzodiazepines are a class of drugsMedication

A pharmaceutical drug, also referred to as medicine or medicament, can be loosely defined as any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease....
with hypnoticHypnotic

Hypnotic drugs induce sleep, used in the treatment of insomnia and in surgical anesthesia. Because drugs in this class generally produce dose-dependent effects, ranging from anxiolysis to production of unconsciousness, they are often referred to collectively as sedative-hypnotic drugs....
, anxiolyticAnxiolytic

An anxiolytic is a Medication prescribed for the treatment of symptoms of anxiety. Some anxiolytics have been shown to be useful in the treatment of anxiety disorders as have antidepressants such as the class of selective serotonin reuptake inhibitors ....
, anticonvulsive, amnesticAmnèsia

Amn?sia is an Italian language drama film directed by Gabriele Salvatores in 2002 in film.External links...
and muscle relaxantMuscle relaxant

A muscle relaxant is a drug which affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia....
properties. Benzodiazepines act as a central nervous system depressant. The relative strength of each of these properties in any given benzodiazepine varies greatly and influences the indications for which it is prescribed. Long-term use can be problematic due to the development of tolerance to the anticonvulsant effects and dependencyAddiction

The term "addiction" is used in many contexts to describe an obsession, compulsion, or excessive physical dependence or psychological dependence, such as: drug addiction, video game addiction, crime, alcoholism, compulsive overeating, problem gambling, computer addiction, pornography addiction, etc....
. Of the many drugs in this class, only a few are used to treat epilepsy:

ClobazamClobazam

Clobazam, , is a drug which is a benzodiazepine derivative. It has been marketed as an anxiolytic since 1975 and an anticonvulsant since 1984....
(1979). Notably used on a short-term basis around menstruation in women with catamenial epilepsy.
ClonazepamClonazepam

Clonazepam is a benzodiazepine derivative with highly potent anticonvulsant, muscle relaxant and anxiolytic properties. It is marketed by Hoffmann-La Roche under the trade-names Klonopin in the United States and Rivotril in various other English speaking countries....
(1974).
ClorazepateClorazepate

Clorazepate , is a drug which is a benzodiazepine derivative. It possesses anxiolytic, anticonvulsant, sedative and skeletal muscle relaxant properties....
(1972).

The following benzodiazepines are used to treat status epilepticusStatus epilepticus

Status epilepticus refers to a life-threatening condition in which the brain is in a state of persistent seizure. Definitions vary, but traditionally it is defined as one continuous unremitting seizure lasting longer than 30 minutes , or recurrent seizures without regaining consciousness between seizures for greater than 30 minutes....
:

DiazepamDiazepam

Diazepam , first marketed as Valium by Hoffmann-La Roche, is a benzodiazepine derivative drug. It possesses anxiolytic, anticonvulsant, hypnotic, sedative, skeletal muscle relaxant and amnestic properties....
(1963). Can be given rectally by trained care-givers.
MidazolamMidazolam

Midazolam, pronounced m?'d?z?l?m is a drug which is a benzodiazepine derivative . It has potent anxiolytic, amnestic, hypnotic, anticonvulsant, skeletal muscle relaxant and sedative properties....
(N/A). Increasingly being used as an alternative to diazepam. This water-soluble drug is squirted into the side of the mouth but not swallowed. It is rapidly absorbed by the buccal mucosaBuccal mucosa

Buccal mucosa is mucous membrane of the inside of the cheek. It is non-keratinised and is continuous with the mucosae of the soft palate, under surface of tongue and the floor of the mouth....
.
LorazepamLorazepam

Lorazepam, initially marketed under the brand names Ativan and Temesta, is a benzodiazepine drug with short to medium duration of action....
(1972). Given by injection in hospital.

NitrazepamNitrazepam

Nitrazepam is a type of benzodiazepine drug and is marketed in English speaking countries under the following brand names - Alodorm, Arem, Insoma, Mogadon, Nitrados, Nitrazadon, Ormodon, Paxadorm, Remnos and Somnite....
, temazepamTemazepam

Temazepam is an intermediate-acting 3-hydroxy benzodiazepine. It is generally prescribed for the short-term treatment of severe or debilitating sleeplessness in patients who have difficulty falling asleep or maintaining sleep....
, and especially nimetazepamNimetazepam

Nimetazepam is a hypnotic drug which is a benzodiazepine derivative which was first synthesized in Japan in 1964. It possesses hypnotic, anxiolytic, sedative, and skeletal muscle relaxant properties....
are powerful anticonvulsant agents, however their use is rare due to an increased incidence of side effects and strong sedative and motor-impairing properties.

Bromides
Main article: BromideBromide

A bromide ion is a bromine atom with electric charge of -1.Compounds with bromine in formal oxidation state -1 are called bromides, and each individual chemical in this class can be called a bromide, as well....
s
Potassium bromidePotassium bromide

Potassium bromide is a salt , widely used as an anticonvulsant and a sedative in the late 19th and early 20th centuries. Its action is due to the bromide ion ....
(1857). The earliest effective treatment for epilepsy. There would not be a better drug for epilepsy until phenobarbital in 1912. It is still used as an anticonvulsant for dogs and cats.

Carbamates
Main article: CarbamateCarbamate

Carbamates, or urethanes, are a group of organic compounds sharing a common functional group with the general structure -NHO-. Carbamates are esters of carbamic acid, NH2COOH, an unstable compound....
s

FelbamateFelbamate

Felbamate is an anticonvulsant drug used in the treatment of epilepsy. It is used to treat seizures in adults and partial and generalized seizures associated with Lennox-Gastaut syndrome in children....
(1993). This effective anticonvulsant has had its usage severely restricted due to rare but life-threatening side effects.

Carboxamides
Main article: CarboxamideCarboxamide

Carboxamides are medication that can be used as anticonvulsants. In organic chemistry carboxamides are functional groups with the general structure R-CO-NH2 with R as an organic substituent....
s

The following are carboxamides:

CarbamazepineCarbamazepine

Carbamazepine is an anticonvulsant and mood stabilizer drug used primarily in the treatment of epilepsy and bipolar disorder. It is also used to treat Attention-deficit hyperactivity disorder, ADHD, schizophrenia, phantom limb syndrome, paroxysmal extreme pain disorder, and trigeminal neuralgia....
(1963). A popular anticonvulsant that is available in generic formulations.
OxcarbazepineOxcarbazepine

Oxcarbazepine is an anticonvulsant and mood stabilizer, used primarily in the treatment of epilepsy and bipolar disorder. As of October 2007, Trileptal has also been available as a generic drug in the United States....
(1990). A derivative of carbamazepine that has similar efficacy but is better tolerated.

Fatty acids
Main article: Fatty acidFatty acid

In chemistry, especially biochemistry, a fatty acid is a carboxylic acid often with a long unbranched aliphatic tail , which is either saturation or Unsaturated compound....
s

The following are fatty-acids:
The valproatesValproic acid

Valproic acid is a chemical compound that has found clinical use as an anticonvulsant and mood stabilizer medication, primarily in the treatment of epilepsy, bipolar disorder, and less commonly major depressive disorder....
— valproic acidValproic acid

Valproic acid is a chemical compound that has found clinical use as an anticonvulsant and mood stabilizer medication, primarily in the treatment of epilepsy, bipolar disorder, and less commonly major depressive disorder....
, sodium valproateSodium valproate

Sodium valproate or valproate sodium is the sodium salt of valproic acid and is an anticonvulsant used in the treatment of epilepsy and bipolar disorder, as well as other psychiatric conditions requiring the administration of a mood stabilizer....
, and divalproex sodium (1967).
VigabatrinVigabatrin

Vigabatrin is an anticonvulsant that inhibits the catabolism of GABA. It is an analog of GABA, but it is not a Receptor agonist. It is manufactured and distributed by Ovation Pharma....
(1989).
ProgabideProgabide

Progabide is an analog and prodrug of gamma-aminobutyric acid used in the treatment of epilepsy. It has agonistic activity at both the GABA A receptor and GABA B receptors....
TiagabineTiagabine

Tiagabine is an anticonvulsant medication produced by Cephalon and marketed under the brand name Gabitril. The drug was discovered at Novo Nordisk in Denmark in 1988....
(1996).

Vigabatrin and progabide are also analogs of GABA.

Fructose derivatives
TopiramateTopiramate

Topiramate is an anticonvulsant drug produced by Ortho-McNeil Neurologics and Noramco, Inc., both being divisions of Johnson & Johnson. It was discovered in 1979 by Drs....
(1995).

Gaba analogs

GabapentinGabapentin

Gabapentin is a Gamma-aminobutyric_acid analogue. It was originally developed for the treatment of epilepsy, and currently, gabapentin is widely used to relieve pain, especially neuropathic pain....
(1993).
PregabalinPregabalin

Pregabalin is an anticonvulsant drug used for neuropathic pain and as an adjunct therapy for partial seizures with or without secondary Seizure_types#Generalized_seizures in adults....
(2004).

Hydantoins
Main article: HydantoinHydantoin

Hydantoin, which is also known as glycolylurea, is a heterocyclic organic compound that can be thought of as a cyclic "double-condensation reaction" product of glycolic acid and urea....
s

The following are hydantoins:

EthotoinEthotoin

Ethotoin is an anticonvulsant drug used in the treatment of epilepsy. It is a hydantoin, similar to phenytoin. Ethotoin lacks phenytoin's side effects of gingival hyperplasia and hirsutism, however it is less effective....
(1957).
PhenytoinPhenytoin

Phenytoin sodium is a commonly used antiepileptic. Phenytoin acts to dampen the unwanted, runaway brain activity seen in seizure by reducing electrical conductance among brain cells by stabilizing the inactive state of voltage gated sodium channels....
(1938).
MephenytoinMephenytoin

Mephenytoin is a hydantoin, used as an anticonvulsant. It was introduced approximately 10 years after phenytoin, in the late 1940s. The significant metabolite of mephenytoin is nirvanol , which was the first hydantoin ....
FosphenytoinFosphenytoin

Fosphenytoin is a water-soluble phenytoin prodrug used only in hospitals for the treatment of epileptic seizures.On 18 November 2004, Sicor received a tentative approval letter from the United States Food and Drug Administration for a generic version of fosphenytoin....
(1996).

Oxazolidinediones
Main article: OxazolidinedioneOxazolidinedione

The following are oxazolidinediones:*paramethadione*trimethadione*ethadione...
s

The following are oxazolidinediones:

ParamethadioneParamethadione

Paramethadione is an anticonvulsant in the oxazolidinedione class. It is associated with fetal trimethadione syndrome, which is also known as paramethadione syndrome....
TrimethadioneTrimethadione

Trimethadione is an oxazolidinedione anticonvulsant. It is used to treat epileptic conditions that are resistant to other treatments; recent studies by Doctor Jianxin Bao, Ph.D., at Washington University in Saint Louis's Central Institute For The Deaf's Center For Presbyacusis and Aging suggest that trimethadione, along with other oxazolidine...
(1946).
EthadioneEthadione

Ethadione is an anticonvulsant medication in the oxazolidinedione family.See also*paramethadione*trimethadione...

Propionates
Main article: PropionatePropionate

The propionate ion is Carbon2Hydrogen5COxygenO− .A propionate or propanoate compound is a salt or ester of propionic acid....
s

BeclamideBeclamide

Beclamide is a propionateIt possesses anticonvulsant activity....

Pyrimidinediones
Main article: PyrimidinedionePyrimidinedione

Pyrimidinediones are a class of chemical compounds characterized by a pyrimidine ring subsubstituted with two carbonyl groups.Examples include naturally occuring metabolites:...
s

PrimidonePrimidone

Primidone is an anticonvulsant of the pyrimidinedione class whose active metabolites, phenobarbital and phenylethylmalonamide , are also anticonvulsants....
(1952).

Pyrrolidines
Main article: PyrrolidinePyrrolidine

Pyrrolidine, also known as tetrahydropyrrole, is an organic compound with the molecular formula C4H9N. It is a cyclic amine with a five-membered ring containing four carbon atoms and one nitrogen atom....
s

BrivaracetamBrivaracetam

Brivaracetam, the 4-n-propyl analog of levetiracetam, is a racetam derivative with anticonvulsant properties. Brivaracetam is believed to act by binding to the ubiquitous synaptic vesicle protein SV2....
LevetiracetamLevetiracetam

Levetiracetam is an anticonvulsant medication used to treat epilepsy. It is S- enantiomer of etiracetam, structurally similar to the prototypical nootropic drug piracetam....
(1999).
SeletracetamSeletracetam

Seletracetam is a drug of the racetam family. It is currently being developed by UCB Pharmaceuticals as an anticonvulsant drug. While similar in structure to so-called nootropic drugs, it is not expected to have cognitive enhancing properties....

Succinimides
Main article: SuccinimideSuccinimide

Succinimide is a cyclic imide with the formula C4H5NO2. It appears as a white or colorless crystalline solid, and has a faint odor of sweat....
s

The following are succinimides:

EthosuximideEthosuximide

Ethosuximide is a succinimide anticonvulsant, used mainly in absence seizures....
(1955).
PhensuximidePhensuximide

Phensuximide is an anticonvulsant in the succinimide class.External links...
MesuximideMesuximide

Mesuximide is an anticonvulsant medication. It is sold by Pfizer under the tradenames Petinutin and Celontin .References...

Sulfonamides
Main article: SulfonamideSulfonamide (medicine)

File:Sulfonamide.pngFile:Hydrochlorothiazide-2D-skeletal.pngFile:Furosemide.svgThere are several sulfonamide-based groups of drugs. The original antibacterial sulfonamides are synthetic antimicrobial agents that contain the Sulfonamide group....
s
AcetazolamideAcetazolamide

Acetazolamide, sold under the trade name Diamox, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension , altitude sickness, cystinuria, and dural ectasia....
(1953).
Sultiame
MethazolamideMethazolamide

Methazolamide is a carbonic anhydrase inhibitor.References...
ZonisamideZonisamide

Zonisamide is a sulfonamide anticonvulsant approved for use as an Wiktionary:adjunct therapy in adults with seizures....
(2000).

Triazines
Main article: TriazineTriazine

A triazine is one of three organic chemicals, isomeric with each other, whose empirical formula is 333....
s

LamotrigineLamotrigine

Lamotrigine and also Lamitor is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. For epilepsy it is used to treat partial seizures, primary and secondary tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome....
(1990).

Ureas
Main article: UreaUrea

Urea is an organic compound with the chemical formula 2carbonoxygen.Urea is also known by the International Nonproprietary Name carbamide, as established by the World Health Organization....
s

PheneturidePheneturide

Pheneturide is an anticonvulsant medication.References...
PhenacemidePhenacemide

Phenacemide is an anticonvulsant of the urea class.External links...

Valproylamides (amide derivatives of valproate)
Main article: AmideAmide

In chemistry, an amide is one of three kinds of compounds:* the organic chemistry functional group characterized by a carbonyl group linked to a nitrogen atom , or a compound that contains this functional group ; or...
s

ValpromideValpromide

Valpromide is a carboxamide derivative of valproic acid used in the treatment of epilepsy and some affective disorders. It is rapidly metabolised to valproic acid but has anticonvulsant properties itself....
ValnoctamideValnoctamide

Valnoctamide has been used in France as an sedative-hypnotic since 1964. It is a structural isomer of valpromide, a valproic acid prodrug; unlike valpromide, however, valnoctamide is not transformed into its acid, valnoctic acid, in vivo....

Diet

The ketogenic dietKetogenic diet

The ketogenic diet is a high fat, adequate protein, low-carbohydrate diet, primarily used to treat difficult-to-control epilepsy in children. The diet mimics aspects of starvation by forcing the body to burn fat rather than carbohydrate....
is a strict medically supervised diet that has an anticonvulsant effect. It is typically used in children with refractory epilepsy.

Devices

The vagus nerve stimulatorVagus nerve stimulation

Vagus nerve stimulation is an adjunctive treatment for certain types of intractable epilepsy and major depressive disorder. VNS uses an implanted stimulator that sends electric impulses to the left vagus nerve in the neck via a lead wire implanted under the skin....
(VNS) is a device that sends electric impulses to the left vagus nerveVagus nerve

The vagus nerve is the tenth of twelve paired cranial nerves, and is the only nerve that starts in the brainstem and extends, through the jugular foramen, down below the head , to the neck, chest and abdomen, where it contributes to the innervation of the viscera....
in the neck via a lead implanted under the skin. It was FDA approved in 1997 as an adjunctive therapy for partial-onset epilepsy.

Marketing approval history

The following table lists anticonvulsant drugs together with the date their marketing was approved in the US, UK and France. Data for the UK and France is incomplete. In recent years, the European Medicines AgencyEuropean Medicines Agency

The European Medicines Agency is a European agency for the evaluation of medication. From 1995 to 2004, the European Medicines Agency was known as The European Agency for the Evaluation of Medicinal Products....
has approved drugs throughout the European UnionEuropean Union

The European Union is an economic and political union of 27 European Union member state, located primarily in Europe. It was established by the Treaty of Maastricht on 1 November 1993 upon the foundations of the pre-existing European Economic Community....
. Some of the drugs are no longer marketed.

Drug Brand US UK France
acetazolamideAcetazolamide

Acetazolamide, sold under the trade name Diamox, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension , altitude sickness, cystinuria, and dural ectasia....
Diamox 1953-07-271953-07-27 1988
carbamazepineCarbamazepine

Carbamazepine is an anticonvulsant and mood stabilizer drug used primarily in the treatment of epilepsy and bipolar disorder. It is also used to treat Attention-deficit hyperactivity disorder, ADHD, schizophrenia, phantom limb syndrome, paroxysmal extreme pain disorder, and trigeminal neuralgia....
Tegretol 1974-07-151974-07-15 1965 1963
clobazamClobazam

Clobazam, , is a drug which is a benzodiazepine derivative. It has been marketed as an anxiolytic since 1975 and an anticonvulsant since 1984....
Frisium 1979
clonazepamClonazepam

Clonazepam is a benzodiazepine derivative with highly potent anticonvulsant, muscle relaxant and anxiolytic properties. It is marketed by Hoffmann-La Roche under the trade-names Klonopin in the United States and Rivotril in various other English speaking countries....
Klonopin/Rivotril 1975-06-041975-06-04 1974
diazepamDiazepam

Diazepam , first marketed as Valium by Hoffmann-La Roche, is a benzodiazepine derivative drug. It possesses anxiolytic, anticonvulsant, hypnotic, sedative, skeletal muscle relaxant and amnestic properties....
Valium 1963-11-151963-11-15
divalproex sodium Depakote 1983-03-101983-03-10
ethosuximideEthosuximide

Ethosuximide is a succinimide anticonvulsant, used mainly in absence seizures....
Zarontin 1960-11-021960-11-02 1955 1962
ethotoinEthotoin

Ethotoin is an anticonvulsant drug used in the treatment of epilepsy. It is a hydantoin, similar to phenytoin. Ethotoin lacks phenytoin's side effects of gingival hyperplasia and hirsutism, however it is less effective....
Peganone 1957-04-221957-04-22
felbamateFelbamate

Felbamate is an anticonvulsant drug used in the treatment of epilepsy. It is used to treat seizures in adults and partial and generalized seizures associated with Lennox-Gastaut syndrome in children....
Felbatol 1993-07-291993-07-29
fosphenytoinFosphenytoin

Fosphenytoin is a water-soluble phenytoin prodrug used only in hospitals for the treatment of epileptic seizures.On 18 November 2004, Sicor received a tentative approval letter from the United States Food and Drug Administration for a generic version of fosphenytoin....
Cerebyx 1996-08-051996-08-05
gabapentinGabapentin

Gabapentin is a Gamma-aminobutyric_acid analogue. It was originally developed for the treatment of epilepsy, and currently, gabapentin is widely used to relieve pain, especially neuropathic pain....
Neurontin 1993-12-301993-12-30 1993-05May 1993 1994-10October 1994
lamotrigineLamotrigine

Lamotrigine and also Lamitor is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. For epilepsy it is used to treat partial seizures, primary and secondary tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome....
Lamictal 1994-12-271994-12-27 1991-10October 1991 1995-05May 1995
levetiracetamLevetiracetam

Levetiracetam is an anticonvulsant medication used to treat epilepsy. It is S- enantiomer of etiracetam, structurally similar to the prototypical nootropic drug piracetam....
Keppra 1999-11-301999-11-30 2000-09-292000-09-29 2000-09-292000-09-29
mephenytoinMephenytoin

Mephenytoin is a hydantoin, used as an anticonvulsant. It was introduced approximately 10 years after phenytoin, in the late 1940s. The significant metabolite of mephenytoin is nirvanol , which was the first hydantoin ....
Mesantoin 1946-10-231946-10-23
metharbitalMetharbital

Metharbital was patented in 1905 by Hermann Emil Fischer working for Merck KGaA. It was marketed as Gemonil by Abbott Laboratories. It is a barbiturate anticonvulsant, used in the treatment of epilepsy....
Gemonil 1952
methsuximide Celontin 1957-02-081957-02-08
methazolamideMethazolamide

Methazolamide is a carbonic anhydrase inhibitor.References...
Neptazane 1959-01-261959-01-26
oxcarbazepineOxcarbazepine

Oxcarbazepine is an anticonvulsant and mood stabilizer, used primarily in the treatment of epilepsy and bipolar disorder. As of October 2007, Trileptal has also been available as a generic drug in the United States....
Trileptal 2000-01-142000-01-14 2000
phenobarbitalPhenobarbital

Phenobarbital or phenobarbitone is a barbiturate, first marketed as Luminal by Bayer. It is the most widely used anticonvulsant worldwide and the oldest still commonly used....
1912 1920
phenytoinPhenytoin

Phenytoin sodium is a commonly used antiepileptic. Phenytoin acts to dampen the unwanted, runaway brain activity seen in seizure by reducing electrical conductance among brain cells by stabilizing the inactive state of voltage gated sodium channels....
Dilantin/Epanutin 1938 1938 1941
phensuximidePhensuximide

Phensuximide is an anticonvulsant in the succinimide class.External links...
Milontin 1953
pregabalinPregabalin

Pregabalin is an anticonvulsant drug used for neuropathic pain and as an adjunct therapy for partial seizures with or without secondary Seizure_types#Generalized_seizures in adults....
Lyrica 2004-12-302004-12-30 2004-07-062004-07-06 2004-07-062004-07-06
primidonePrimidone

Primidone is an anticonvulsant of the pyrimidinedione class whose active metabolites, phenobarbital and phenylethylmalonamide , are also anticonvulsants....
Mysoline 1954-03-081954-03-08 1952 1953
sodium valproateSodium valproate

Sodium valproate or valproate sodium is the sodium salt of valproic acid and is an anticonvulsant used in the treatment of epilepsy and bipolar disorder, as well as other psychiatric conditions requiring the administration of a mood stabilizer....
Epilim 1977-12December 1977 1967-06June 1967
stiripentolStiripentol

Stiripentol is an anticonvulsant drug used in the treatment of epilepsy. It is unrelated to other anticonvulsants and belongs to the group of aromatic allyl alcohols....
Diacomit 2001-12-052001-12-05 2001-12-052001-12-05
tiagabineTiagabine

Tiagabine is an anticonvulsant medication produced by Cephalon and marketed under the brand name Gabitril. The drug was discovered at Novo Nordisk in Denmark in 1988....
Gabitril 1997-09-301997-09-30 1998 1997-11November 1997
topiramateTopiramate

Topiramate is an anticonvulsant drug produced by Ortho-McNeil Neurologics and Noramco, Inc., both being divisions of Johnson & Johnson. It was discovered in 1979 by Drs....
Topamax 1996-12-241996-12-24 1995
trimethadioneTrimethadione

Trimethadione is an oxazolidinedione anticonvulsant. It is used to treat epileptic conditions that are resistant to other treatments; recent studies by Doctor Jianxin Bao, Ph.D., at Washington University in Saint Louis's Central Institute For The Deaf's Center For Presbyacusis and Aging suggest that trimethadione, along with other oxazolidine...
Tridione 1946-01-251946-01-25
valproic acidValproic acid

Valproic acid is a chemical compound that has found clinical use as an anticonvulsant and mood stabilizer medication, primarily in the treatment of epilepsy, bipolar disorder, and less commonly major depressive disorder....
Depakene/Convulex 1978-02-281978-02-28 1993
vigabatrinVigabatrin

Vigabatrin is an anticonvulsant that inhibits the catabolism of GABA. It is an analog of GABA, but it is not a Receptor agonist. It is manufactured and distributed by Ovation Pharma....
Sabril 1989
zonisamideZonisamide

Zonisamide is a sulfonamide anticonvulsant approved for use as an Wiktionary:adjunct therapy in adults with seizures....
Zonegran 2000-03-272000-03-27 2005-03-102005-03-10 2005-03-102005-03-10

See also
ATC code N03ATC code N03

N03 Antiepileptics is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System.It is part of the anatomical group ATC code N....

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